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The Doctor, the God and the Consultant

Did you ever think about who your doctor is? Is he a just a plain Doctor, God or the Consultant?
Before the 20th century, the doctor was the person who deeply cared about you, but he had little power against death. Doctors were purely dedicated to the good of people in the most humanitarian sense you can imagine. Patients and making those patients better was all that mattered. This character is wonderfully depicted in Sir Fildes’ wonderful painting “The Doctor”.

The Doctor exhibited 1891 by Sir Luke Fildes 1843-1927

Fildes paints this deeply concerned, careful and wise man in the bedside of a poor worker’s daughter. The worried mom and the dad is at the bed are looking at the doctor with little hope and mostly desperation. This mix of hope and desperation is an absolutely accurate reflection of the medicine in pre-20th century.

In this era, despite all the good intentions doctors were powerless and desperate against death. They had limited knowledge of the world in micro-scale (Ronald Ross discovered malaria is spread through mosquitos in 1897), and had very little technology assist them. Fildes’ painted precisely depict this deeply concerned Doctor who wants to do something, but his hands are tied.

Then comes the 20th century, especially the second half. With the advancements in the biological and microbiological knowledge, help of anesthetics, vast technological progress and two unfortunate World Wars; we start to see another type of doctor: The God. Unlike the pre-20th century counterpart, this new Doctor was fearless against the death. He believed that he can conquer the death, and by many senses he did. In 20th century, we saw an incredible increase in life expectancy, eradication of “simple” yet harmful diseases and successful efforts to prolong life with efforts like organ transplantations.

The doctor in the 20th century is the God. He knows and does what is best for you. He is a Western, paternalistic and educated figure. You can’t really argue with him, since his science (theoretically) has no limit.

Guess what, medicine changed and changing once again.

Today’s medical problems are becoming more and more complicated; and even the Doctor/God is weak now. He spends more, has better technology and understands the problems in nano scale; yet he can’t stop people from getting sick.

Personally I believe chronic conditions, cancer and internet marks today’s medicine. Internet made the most democratic revolution in knowledge. With couple Google searches, although limited, you will have a great understanding of your condition. You need emotional cure and support as much as physical and biological, and this is precisely the point the doctor of the 20th century fails. This educated, Western man is also a distant figure.

Now, the burden of the disease is emotional. You don’t fight cancer part time; it’s a full time job. Soon you’ll realize your doctor is not around all the time. How come he can know the best for you if he doesn’t know you?

This needy and emotionally stressed patient is becoming more and more empowered. Now the doctor’s job is to consult the patient on the course of disease and the treatment options. He is more of guide than almighty figure. The doctor is the consultant now.

This is such a new concept. If you’re in a newly developing country it is quite likely that you will see more of the God figure than the consultant. However, the care environment is dramatically changing in the developed world.

We don’t know what the big revolution in the healthcare yet, mobile care, distant care, international care etc. But for sure the next big thing will revolve around the patient.


Image source: Flickr

Murat Uralkan

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